Residential Intellectual and Developmental Disability Facilities NAICS 623210

        Residential Intellectual and Developmental Disability Facilities

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Industry Summary

The 7,300 residential intellectual and developmental disability (IDD) facilities primarily provide room, board, protective supervision, and counseling to individuals with IDD. Residential care centers or group homes are state-licensed facilities that offer non-medical support services for people who need individualized attention due to disability for up to 24 hours per day. Intermediate care facilities for individuals with IDD (ICF/IDD) provide long-term care, including nursing or supportive care, on doctor’s orders and serve patients that need a higher level of care than a residential care facility but a lower level than a skilled nursing facility. A small percentage of individuals live with a host or foster family who provides care.

Dependence on Medicaid

Medicaid has long been the primary funding source for long-term supports and services (LTSS) for individuals with IDD.

Vulnerable Client Base

The population of individuals with IDD is vulnerable and at risk for neglect, harm, or abuse.


Recent Developments

Feb 4, 2026 - Some States Expand ACA Subsidies
  • Six states have taken measures to offset the cost of Affordable Care Act (ACA) plans after a lapse in federal funding left millions of Americans facing higher premiums, according to Healthinsurance.org. Residential intellectual disability facilities may be negatively impacted if patients refuse services because they cancelled their insurance policies due to affordability issues. California, Colorado, Connecticut, Maryland, Massachusetts, and New Mexico have increased their state-funded ACA subsidies for 2026 in response to the expiration of federal tax credits at the end of 2025. The states "modified or enhanced their programs directly to address the reduction in federal premium subsidies," said Louise Norris, a health policy analyst for Healthinsurance. Nonprofit health group KFF reports that several states, especially those operating what are known as State-Based Marketplaces, have been preparing for the lapse of ACA tax credits for months. New Mexico, for example, will fully offset the loss of the federal tax credits for all residents, including recent immigrants. Ten states offer ACA subsidies but only six have increased them since federal subsidies lapsed.
  • Federal health officials are launching a $2-million competition to attract new ideas for how technology can transform caregiving for people with disabilities and others. The Caregiver Artificial Intelligence Prize Competition is intended to fund innovative ideas that use AI to support both paid and family caregivers in providing care at home as well as ways to support employers in the caregiving workforce to strengthen efficiency, scheduling, and training. The workforce of paid direct support professionals has been in crisis for years with low pay leading to perpetually high turnover rates, according to Disability Scoop.
  • Private equity (PE) firms have become dominant players in the market for autism services since the mid-2010s, according to The Center for Economic and Policy Research (CEPR). Some residential intellectual disability facilities provide care for those with autism spectrum disorder. PE firms have bought out many provider organizations across the country and created national chains. The buyout of existing providers does not necessarily lead to the needed expansion of services or the opening of new sites, according to the CEPR. Autism services became a ‘hot market’ for PE acquisitions only after widespread health insurance coverage became available by the mid-2010s, according to the CEPR. This occurred through passage of state health insurance mandates, the Affordable Care Act mandate for coverage in its marketplace health plans, and the Medicaid mandate for coverage in 2014 of medically necessary services in behavioral health, including people with autism. Private equity firms completed 85% of all industry mergers and acquisitions in autism services between 2017 and 2022 – a rate not found in any other segment.
  • Residential intellectual and developmental disability facilities increased prices 4.32%% year over year in November 2025, according to the US Bureau of Labor Statistics (BLS). Residential intellectual disability facility industry employment and average wages for nonsupervisory employees increased slightly during the first 11 months of 2025, according to the BLS. Residential intellectual disability facility sales are forecast to grow at a 6.94% compounded annual rate from 2025 to 2029, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund, Inc.

Industry Revenue

Residential Intellectual and Developmental Disability Facilities


Industry Structure

Industry size & Structure

The average residential intellectual and developmental disability (IDD) facility employs about 75 workers and generates just over $5 million annually.

    • The residential IDD facility industry consists of about 7,300 firms that employ over 535,000 workers and generate over $37 billion annually.
    • Almost one-third of companies are tax-exempt organizations.
    • The industry is fragmented; the top 50 companies account for less than 25% of industry revenue.
    • Most large firms, such as ResCare and Sevita, are regional or multi-state operators
    • Firms that generate less than $1 million annually account for over 40% of the industry. Firms that generate $5 million annually or more account for more than 60% of total industry sales.

                                Industry Forecast

                                Industry Forecast
                                Residential Intellectual and Developmental Disability Facilities Industry Growth
                                Source: Vertical IQ and Inforum

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